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    Swine Flu in Japan May Trigger Pandemic

    In U.S., 8 New York City Schools Closed as H1N1 Swine Flu Spreads Across Nation
    WebMD Health News
    Reviewed by Louise Chang, MD

    May 18, 2009 -- H1N1 swine flu appears to be spreading in Japan, pushing the world to the brink of an official flu pandemic.

    Japan's cases of H1N1 spiked today with 104 new lab-confirmed cases, raising that nation's swine-flu case count from 25 to 129. Ten schools in the Kobe City area reported 78 of the new cases.

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    If the new cases do indeed represent "community-level sustained transmission" of the virus in Asia, it would be the second region of the world to have wide spread of H1N1 swine flu. That would meet the official WHO criteria for moving from the current level 5 pandemic alert to the ultimate level 6 alert.

    Aside from the emotional shock, the formal pandemic declaration won't mean a lot to the U.S., Anne Schuchat, MD, the CDC's interim deputy director for science, said at a news conference.

    "We have seen sustained spread of this virus in the U.S. and are acting aggressively, so a change from level 5 to level 6 will have less effect on us than on other regions that have done less to deal with virus," she said.

    Declaration of a pandemic does not mean that the virus has become more deadly, only that it is spreading more widely around the globe.

    While H1N1 swine flu does appear more dangerous than seasonal flu bugs -- especially for older children, teens, and young adults -- the vast majority of cases have been relatively mild.

    "From the virus strains we have tested we see no indication of a change to more virulent strain. But viruses do change and we will continue looking at this," Schuchat said.

    Even so, the U.S. has recorded its sixth swine flu fatality, a 55-year-old assistant principal at a school in the New York City borough of Queens. The city has closed eight schools in Queens and Brooklyn; news reports suggest that 40 other New York schools have high absentee rates.

    Despite the worrisome news from New York, Schuchat said the swine flu is now spreading most quickly in the Pacific Northwest and in the Southwest. Case counts -- 5,123 as of today -- are "the tip of the iceberg."

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